MEDICARE: DR. JAMES B. MADELEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	018403	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073500401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES B. MADELEY M.D.

Provider Business Mailing Address
First Line	:	2680 LAWRENCEVILLE HWY
Second Line	:	SUITE 100
City	:	DECATUR
State	:	GA
Zip	:	30033-2526
Country	:	US
Telephone Number	:	770-491-3003
Fax Number	:	770-491-0729

Provider Business Practice Location Address
First Line	:	2680 LAWRENCEVILLE HWY
Second Line	:	SUITE 100
City	:	DECATUR
State	:	GA
Zip	:	30033-2526
Country	:	US
Telephone Number	:	770-491-3003
Fax Number	:	770-491-0729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	07/08/2007

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